Treatment of subclinical hyperthyroidism in patients older than 50 years: a randomized controlled study
Authors' conclusion
Due to recruitment difficulties this study failed to demonstrate that SCH treatment can reduce significantly the incidence of AF in patients older than 50 years with thyroid autonomy even if all the patients who developed AF maintained TSH <0.4 mU/L. This result must be balanced with the increased risk of radioiodine-induced hypothyroidism.
Study context
- Population
- Patients ≥50 years with subclinical hyperthyroidism (SCH) (TSH <0.4 mU/L, normal thyroid hormones) and autonomy on thyroid scan; mean age 65.3±8.9y, 76% femalerandomized
- Participants
- 144 patients
- Comparison
- Radioiodine vs surveillance
- Treatmentn = 70
- Surveillancen = 74reference
- Primary endpoint
- Onset of new AF
Methodological detailsRecruitment difficulties
- Recruitment difficulties
Primary result
As reported in the abstract
New AF
Surveillance
4
events
Treatment
1
events
P = 0.238
Secondary outcomes
AF risk when TSH normalization considered (post-hoc analysis)
- Risk of AF significantly reduced with TSH normalization
- P = 0.0003
- Post-hoc analysis
Safety
Radioiodine-induced hypothyroidism · during follow-up
- Hypothyroidism among 94 patients treated with radioiodine
- 25%
Original publication
Treatment of subclinical hyperthyroidism in patients older than 50 years: a randomized controlled study. Eur Thyroid J. Published 6 November 2024. doi:10.
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